Prevalence of flu-like syndrome in healthcare workers in Brazil: a national study, 2020

ABSTRACT OBJECTIVE To evaluate the prevalence of reported symptoms of flu-like syndrome (FS) among HCW and compare HCW and non-HCW on the chance of reporting these symptoms, this study analyzed data of a population-based survey conducted in Brazil. METHODS A cross-sectional analysis was performed with self-reported data from the Brazilian National Household Sample Survey (PNAD Covid-19) from May 2020. The authors analyzed a probability sample of 125,179 workers, aged 18 to 65, with monthly income lower than US$ 3 500. The variable HCW or non-HCW was the covariate of interest and having reported FS symptoms or not was the outcome variable. Authors tested interactions of HCW with other covariates. A logit model - when controlling for sociodemographic, employment, and geographic characteristics - investigated the chance of HCW reporting FS compared to non-HCW. RESULTS HCW have a significant effect (odds ratio of 1.369) on reporting FS symptoms when compared to non-HCW. HCW account for 4.17% of the sample, with a higher frequency of FS (3.38%) than observed for non-HCW (2.43%). Female, non-white and older individuals had higher chance to report FS. CONCLUSIONS The HCW had a higher chance of reporting symptoms than non-HCW aged over 18 years in the labor force. These results emphasize guidelines for preventive measures to reduce workplace exposures in the healthcare facilities. The prevalence is disproportionately affecting HCW women and HCW non-whites. In the regions North and Northeast the steeper progression is consistent with the hypothesis of socioeconomic factors, and it explains the greater prevalence in HCW and non-HCW living in those territories.

Health care professionals' conceptions of respiratory symptoms and physical activity in patients with acute pulmonary embolism. A phenomenographic interview study.

INTRODUCTION: Acute pulmonary embolism (PE) often presents with respiratory symptoms, such as dyspnea and respiratory pain, and patients are affected both physically and mentally by the consequences of PE for a long time after the event. This study aimed to explore health care professionals (HCPs) conceptions of respiratory symptoms, physical activity, and information given to patients during in-hospital care. MATERIALS AND METHODS: Qualitative individual interviews were conducted with twenty-one HCPs (physicians, nurses, physiotherapist) working with patients with PE, and analyzed with a phenomenographic approach. RESULTS: The findings resulted in an overall theme: "Health care professionals' knowledge of PE, and an individualized patient approach, are cornerstones for adequate management of respiratory symptoms in PE". Three major categories described conceptions of a heterogenous patient group physically and mentally affected by their respiratory symptoms, of accurate information given at right time being crucial, and of giving appropriate information about respiratory symptoms and physical activity being complex due to many prerequisites needing to be fulfilled. CONCLUSIONS: This study provides new knowledge about the complexity of management of patients with PE and respiratory symptoms. The patient group was conceived as heterogenous with different needs for information given at the appropriate time. Structural prerequisites, such as time and staff rotation in the hospital setting, and personal issues, for example levels of knowledge of PE among HCPs affected the ability of HCPs to give correct information. Further research is needed to ensure optimal design of in-hospital care for patients with PE.

Validade de conteúdo dos indicadores clínicos de desobstrução ineficaz de vias aéreas / Validez de contenido de los indicadores clínicos de desobstrucción ineficaz de las vías aéreas / Content validity of ineffective airway clearance clinical indicators

Resumo Objetivo Identificar os indicadores clínicos mais relevantes para o Diagnóstico de Enfermagem Desobstrução ineficaz de vias aéreas. Método Estudo metodológico de análise de conteúdo organizado em três fases: definição conceitual do fenômeno de interesse, construção da estrutura do fenômeno de interesse e análise dos juízes sobre a estrutura construída. Resultados Foram identificados 21 indicadores clínicos. Apenas Sons respiratórios aumentados e Retração subcostal não foram indicadores significativamente relevantes para o diagnóstico. Conclusão Os indicadores de maior relevância para o diagnóstico Desobstrução ineficaz de vias aéreas foram: Dispneia, Mudanças no ritmo respiratório, Ruídos adventícios respiratórios, Taquipneia, Acúmulo excessivo de muco, Tosse ineficaz, Sons respiratórios diminuídos, Ortopneia, Cianose, Inquietação, Dificuldade para verbalizar e Uso da musculatura acessória para respirar.

Resumen Objetivo Identificar a los indicadores clínicos más relevantes para el Diagnóstico de Enfermería Desobstrucción ineficaz de las vías aéreas. Métodos Estudio metodológico de análisis de contenido organizado em tres fases: definición conceptual del fenómeno de interés, construcción de la estructura del fenómeno de interés y análisis de los jueces sobre la estructura construida. Resultados Se identificaron 21 indicadores clínicos. Únicamente Sonidos respiratorios aumentados y Retracción subcostal no fueron indicadores significantemente relevantes para el diagnóstico. Conclusión Los indicadores de mayor relevancia para el diagnóstico Desobstrucción ineficaz de las vías aéreas fueron: Disnea, Cambios en el ritmo respiratorio, Ruidos adventicios respiratorios, Taquipnea, Acúmulo excesivo de mucosidad, Tos ineficaz, Sonidos respiratorios disminuidos, Ortopnea, Cianosis, Inquietud, Dificultad para verbalizar y Uso de la musculatura accesoria para respirar.

Abstract Objective To identify the most relevant clinical indicators for the Ineffective airway clearance Nursing Diagnosis. Method This is a methodological study of content analysis organized into a conceptual definition of the phenomenon of interest, construction of the phenomenon of interest structure and analysis by judges on the constructed structure. Results Twenty-one clinical indicators were identified. Only Increased breath sounds and Subcostal retraction were not significantly relevant for the diagnosis. Conclusion The most relevant indicators for the Ineffective airway clearance diagnosis were: Dyspnea, Alteration in respiratory rate, Adventitious respiratory noises, Tachypnea, Excessive sputum, Ineffective cough, Decreased breathing sounds, Orthopnea, Cyanosis, Restlessness, Difficulty verbalizing and Use of accessory muscles to breathe.

Effect of peramivir on respiratory symptom improvement in patients with influenza virus infection and pre-existing chronic respiratory disease: Findings of a randomized, open-label study.

BACKGROUND: The efficacy of neuraminidase inhibitors on improvement of respiratory symptoms triggered by influenza in patients with pre-existing chronic respiratory diseases is unknown. METHODS: This 2-week, randomized, open-label study evaluated intravenous peramivir 600 mg on two consecutive days (peramivir-repeat), peramivir 300 mg single dose (peramivir-single), and oral oseltamivir 75 mg twice daily for 5 days in patients with confirmed influenza and chronic respiratory diseases. Patients recorded symptom scores daily. The primary endpoint of cumulative area of time vs symptoms (CATVS) was expressed as an index value of area under the curve vs time of the total score of cough, sore throat, and nasal congestion from baseline to 2 weeks. RESULTS: Of 214 randomized patients, 209 (56% female, 77% aged <65 years, 94% outpatients, 91% bronchial asthma, 62% influenza A) received ≥1 dose of study drug. Mean (standard deviation) CATVS was similar for peramivir-repeat (782.78 [487.17]) vs peramivir-single (717.35 [347.55]; P = .4371), and for peramivir-repeat vs oseltamivir (856.34 [404.99]; P = 1.00). However, CATVS was significantly shorter for peramivir-single vs oseltamivir, with an estimated treatment difference (TD) of -145.07 (95% confidence interval: -284.57, -5.56; P = .0416). In subgroup analyses, CATVS was significantly shorter for peramivir-single vs oseltamivir among patients with influenza A (TD: -206.31 [-383.86, -28.76]; P = .0231), bronchial asthma (TD: -156.57 [-300.22, -12.92]; P = .0328), baseline respiratory severity score <5 (TD: -265.32 [-470.42, -60.21]; P = .0120), and age <65 (TD: -184.30 [-345.08, -23.52]; P = .0249). CONCLUSIONS: In patients with chronic respiratory diseases, peramivir-single was not significantly different from peramivir-repeat and was more effective than oseltamivir at alleviating respiratory symptoms.

[Diagnostics of acute and chronic cough in primary care]. / Diagnostik bei akutem und chronischem Husten in der hausärztlichen Versorgung.

Cough is one of the most frequent causes for consultation in primary care. The diagnostic characteristics in primary care with a broad spectrum of causes and unspecific symptoms are presented using the example of acute and chronic cough. The understanding of the formation of the cough stimulus and the induction by inflammatory, mechanical and chemical triggers as well as the significance of the stimulus threshold of the cough receptor facilitate the comprehension of the various possible causes of cough. The necessary diagnostic procedures are based on the exclusion of warning symptoms that necessitate emergency inpatient treatment, on the duration of symptoms and the spectrum of causes to be expected from them. Ambiguities often remain even with careful basic diagnostics. Watchful waiting and active surveillance can initially be the most sensible approach but should not be misconstrued as carelessness. It necessitates follow-up controls and increased attention especially in patients with a high-risk constellation (e.g. multimorbidity, immune suppression, heart failure) in order to be able to quickly react to the development of treatable aspects or even dangerous courses of disease.

Predicting life expectancy of older people using respiratory symptoms and smoking status: Data from the Australian Longitudinal Study of Ageing.

BACKGROUND AND OBJECTIVE: Respiratory symptoms are recognizable to patients and may be markers of chronic disease and mortality risk. This risk may be easier to conceptualize if presented as remaining life expectancy (LE) rather than hazard ratios. We aimed to predict the remaining LE of older people with respiratory symptoms using data from the Australian Longitudinal Study of Ageing (ALSA). METHODS: The ALSA is a prospective longitudinal cohort of older Australians (n = 2087) with 22 years of follow-up. The symptoms analysed were cough, shortness of breath (SOB) and wheeze. The implied impact on LE was estimated using a parametric survival function. RESULTS: SOB predicted shorter LE irrespective of smoking status. Cough predicted shorter LE in former smokers and wheeze predicted shorter LE in current smokers. The estimated remaining LE of a 70-year-old male never smoker with no symptoms was 16.6 (95% CI: 14.8-17.7) years. The years of life lost for a 70-year-old male current smoker with cough, SOB and wheeze compared to a never smoker with no symptoms was 4.93 (95% CI: 2.87-7.36) years with only 2.99 (95% CI: 1.35-4.97) years being attributed to their current smoking and the remainder to their respiratory symptoms. CONCLUSION: Respiratory symptoms predict mortality in older people. Cough in former smokers, wheeze in current smokers and all those with SOB require further investigations and disease-specific management.

Symptom variability over the course of the day in patients with stable COPD in Brazil: a real-world observational study / Variabilidade dos sintomas diários de pacientes com DPOC estável no Brasil: um estudo observacional de vida real

ABSTRACT Objective: To analyze symptoms at different times of day in patients with COPD. Methods: This was a multicenter, cross-sectional observational study conducted at eight centers in Brazil. We evaluated morning, daytime, and nighttime symptoms in patients with stable COPD. Results: We included 593 patients under regular treatment, of whom 309 (52.1%) were male and 92 (15.5%) were active smokers. The mean age was 67.7 years, and the mean FEV1 was 49.4% of the predicted value. In comparison with the patients who had mild or moderate symptoms, the 183 (30.8%) with severe symptoms were less physically active (p = 0.002), had greater airflow limitation (p < 0.001), had more outpatient exacerbations (p = 0.002) and more inpatient exacerbations (p = 0.043), as well as scoring worse on specific instruments. The most common morning and nighttime symptoms were dyspnea (in 45.2% and 33.1%, respectively), cough (in 37.5% and 33.3%, respectively), and wheezing (in 24.4% and 27.0%, respectively). The intensity of daytime symptoms correlated strongly with that of morning symptoms (r = 0.65, p < 0.001) and that of nighttime symptoms (r = 0.60, p < 0.001), as well as with the COPD Assessment Test score (r = 0.62; p < 0.001), although it showed only a weak correlation with FEV1 (r = −0.205; p < 0.001). Conclusions: Dyspnea was more common in the morning than at night. Having morning or nighttime symptoms was associated with greater daytime symptom severity. Symptom intensity was strongly associated with poor quality of life and with the frequency of exacerbations, although it was weakly associated with airflow limitation.

RESUMO Objetivo: Analisar os sintomas em diferentes momentos do dia em pacientes com DPOC. Métodos: Estudo observacional multicêntrico de corte transversal em oito centros brasileiros. Foram avaliados os sintomas matinais, diurnos e noturnos em pacientes com DPOC estável. Resultados: Foram incluídos 593 pacientes em tratamento regular, sendo 309 (52,1%) do sexo masculino e 92 (15,5%) fumantes ativos. A média de idade foi de 67,7 anos, e a média de VEF1 foi de 49,4% do valor previsto. Os pacientes com sintomas mais graves (n = 183; 30,8%), em comparação com aqueles com sintomas leves e moderados, apresentaram pior nível de atividade física (p = 0,002), maior limitação ao fluxo aéreo (p < 0,001), exacerbações ambulatoriais (p = 0,002) e hospitalares (p = 0,043) mais frequentemente e piores resultados em instrumentos específicos. Os sintomas matinais e noturnos mais frequentes foram dispneia (em 45,2% e 33,1%, respectivamente), tosse (em 37,5% e 33,3%, respectivamente) e chiado (em 24,4% e 27,0%, respectivamente). Houve forte correlação da intensidade dos sintomas diurnos com sintomas matinais (r = 0,65, p < 0,001), sintomas noturnos (r = 0,60, p < 0,001), bem como com o escore do COPD Assessment Test (r = 0,62; p < 0,001); porém, houve uma correlação fraca com VEF1 (r = −0,205; p < 0,001). Conclusões: A dispneia foi mais frequente no período matinal do que no período noturno. Ter sintomas matinais e/ou noturnos foi associado à pior gravidade dos sintomas diurnos. A intensidade dos sintomas foi fortemente associada a pior qualidade de vida e frequência de exacerbações, mas fracamente associada à limitação ao fluxo aéreo.

Signo del halo invertido como manifestación inhabitual de neumonía organizada criptogénica: reporte de un caso / Reversed halo sign as an unusual manifestation of cryptogenic organized pneumonia: report of one case

We report a 64 years old female admitted with fever, cough, dyspnea and lung opacities in the chest X ray. A chest tomography scan (CTS) showed multiple-bilateral ring-shaped opacities and the reversed halo sign (RHS). The patient did not improve with antimicrobial therapy (AT). Infection and rheumatologic causes were excluded, therefore Cryptogenic organizing pneumonia (COP) was suspected with compatible percutaneous biopsy. Systemic steroids were started with a good clinical response. The patient was discharged four weeks after admission in good general conditions and practically no lungs opacities.

Respiratory Exposure to Toxic Gases and Metal Fumes Produced by Welding Processes and Pulmonary Function Tests.

BACKGROUND: Welding is a common industrial process and is harmful to welders' health. OBJECTIVE: To determine the effect of toxic gases and metal fumes produced during 3 welding processes on welders' incidence of respiratory symptoms and pulmonary function. METHODS: This cross-sectional study was conducted in an Iranian shipbuilding industrial factory in 2018. Using the simple census method, 60 welders were selected as the exposed group. 45 staff members of the administrative unit were also recruited to be served as the control group. Welders' demographic data and respiratory complaints were collected employing a questionnaire. Fumes and gases produced were sampled from the welders' respiratory tract and analyzed by standard methods suggested by the National Institute of Occupational Safety and Health (NIOSH). Pulmonary function test was also performed for each participant. RESULTS: The prevalence of respiratory symptoms in all welders was significantly (p<0.05) higher than the control group. The mean FVC, FEV1 and FEV1/FVC measured in welders involved in all 3 processes were significantly lower than those recorded in the control group. The spirometry pattern in welders involved in flux cored arc welding and shielded metal arc welding was obstructive; that in those involved in gas metal arch welding was mixed (obstructive and restrictive pattern). CONCLUSION: Exposure to welding fumes and gases was associated with pulmonary function deterioration. Welders involved in gas metal arch welding had a higher prevalence of pulmonary disorders compared with those involved in gas metal arch welding and flux cored arc welding.

Air pollution and elementary school students’ absenteeism caused by respiratory symptoms and diseases among primary school students / 中国学校卫生

Objective@#To investigate the health effects of air pollution on elementary school students with the indicator of absenteeism caused by respiratory symptoms and diseases, and to provide a reference for improving their physical health.@*Methods@#Absenteeism, air pollutants, and meteorological data during Sep. 2015 to Jun. 2017 in Pudong, Shanghai were collected. Generalized additive model was used to estimate the effects of air pollution on students’ absenteeism caused by respiratory symptom and diseases, time trends, day of week and meteorological factors were controlled.@*Results@#Totally 47 723 person-days of elementary school students’ absenteeism caused by respiratory symptoms and diseases were recorded during Sep.2015 to Jun. 2016 in Pudong, Shanghai, and the absenteeism rate was 0.07%. The PM2.5 concentration on lag0 and SO2 concentration on lag2 showed the most significant effects, the elementary school students’ absenteeism raised for 1.43% (95%CI=0.25%~2.62%)and 6.79% (95%CI=0.25%~13.32%) respectively with every 10 μg/m3 increment of PM2.5 and SO2.@*Conclusion@#Air pollution in Pudong new area have made a influence on the elementary school student’s respiratory symptoms and absenteeism, and the prevention work of air pollution should be strenghthened.

Respiratory and Dermal Symptoms and Raised Serum Concentrations of Biomarkers of Oxidative Stress among Pesticide Retailers.

BACKGROUND: Recently concern has been raised regarding possible health effects resulting from exposure of a group of pesticide retailers to chemicals they handle. OBJECTIVE: To investigate the prevalence of respiratory and dermal symptoms, as well as biomarkers of oxidative stress, among pesticide retailers and to compare them with those of an unexposed comparison group. METHODS: 70 male pesticide retailers and 64 male construction workers (served as the comparison group) were investigated. Blood samples were taken from all participants to assess the biomarkers of oxidative stress. A data sheet and the European Community Respiratory Health Survey II questionnaire were used to determine the prevalence of dermal and respiratory disorders, respectively. RESULTS: After adjusting for age, weight, height, education level, job tenure, average daily work, presence of family history of respiratory diseases, marital status, smoking status, and number of cigarettes smoked per day, we found that wheezing (OR 4.07, 95% CI 1.17 to 14.17), cough (OR 3.38, 95% CI 1.15 to 9.98), and mucus hypersecretion (OR 3.66, 95% CI 1.45 to 9.05) were significantly more prevalent among pesticide retailers compared with the comparison group. The prevalence of tingling and dryness of skin exposed individuals was significantly higher than unexposed participants. The mean serum concentrations of glutathione and malondialdehyde in the exposed group were significantly higher than those in the comparison group. CONCLUSION: Occupational exposure to low doses of a mixture of pesticides by retailers was associated with increased prevalence of dermal and respiratory symptoms as well as raised concentrations of biomarkers of oxidative stress.

Effectiveness of clarithromycin in patients with yellow nail syndrome.

BACKGROUND: Yellow nail syndrome (YNS) is a rare disease characterized by the triad of thickened, slow-growing yellow nails, lymphedema, and chronic respiratory manifestations. The cause of YNS is not known; however, it is suggested to be due to a congenital lymph abnormality. Since YNS is accompanied by chronic bronchial infection in more than half of patients, we hypothesized that treatment with clarithromycin (CAM) could be effective. We therefore evaluated the effectiveness of CAM against nail discoloration and respiratory manifestation in patients with YNS. METHODS: We conducted an observational study involving 5 patients with YNS who were treated at our institution between January 2005 and January 2016. CAM was prescribed for every patient. Patient demographic information, comorbidities, medications, chest radiographs, and clinical data such as nail color were extracted to evaluate clinical outcome. RESULTS: Mean patient age was 71.6 years, and 2 patients (40%) were male. Four patients had sinusitis, and 2 had rheumatoid arthritis. Regarding respiratory manifestations, 4 patients had sinobronchial syndrome and 2 had pleural effusion. Nail discoloration improved in every patient after CAM treatment. Four patients also experienced improvement in their respiratory manifestations. CONCLUSIONS: In patients with YNS, the anti-inflammatory activity of macrolides might improve their systemic inflammation. This improvement could help to reduce lymphedema and promote nail growth. TRIAL REGISTRATION: Ethical approval was provided by the institutional review board of the National Center of Global Health and Medicine (NCGM-G-002143-00), in January 2017. This study is retrospectively registered for UMIN Clinical Trial Registry ( UMIN000028514 ) in August 4th, 2017.

Prevalência de sintomas respiratórios em servidores de bibliotecas de uma universidade pública / Prevalence of respiratory symptoms in library workers in a public university

Introdução: Os servidores passam um terço do dia no ambiente de trabalho, podendo ser um fator desencadeante de doenças ocupacionais, destacando-se os problemas respiratórios.Objetivo: Descrever a prevalência de sintomas respiratórios em profissionais de bibliotecas de uma universidade pública do sul do Brasil. Materiais e métodos: O projeto desenvolveu-se entre 2015 e 2016. A amostra conta com servidores de ambos os sexos, respondendo a dois instrumentos de coleta de dados: questionário respiratório e questionário de Fargestron para dependência ao tabagismo. Resultados: Foram selecionadas 14 bibliotecas da instituição, 136 trabalhadores, sendo 68% mulheres, e 32% homens. Destes, 44% relataram sintomas como, tosse com secreção (36%), tosse seca (23%), cansaço (19%), chiado (9%), dor no peito (5%). Das patologias, bronquite (40%), rinite (23%), foram as mais relatadas. Conclusão: É necessária maior participação de profissionais da saúde em ambientes de trabalho como bibliotecas, visando promover aos servidores, saúde, segurança e educação no trabalho. (AU)

INTRODUCTION: Public servants spend a third of the day in the work environment, which can be a triggering factor for occupational diseases, especially respiratory problems. OBJECTIVE: To describe the prevalence of respiratory symptoms in professionals working in libraries of a public university in the south of Brazil. MATERIALS AND METHODS: The project was developed between 2015 and 2016. The sample has employees of both genders, responding to two instruments of data collection: respiratory questionnaire and Fargestron questionnaire for smoking dependence. RESULTS: Fourteen libraries of the institution were selected, with 136 workers, 68% female, and 32% male. Of these, 44% reported symptoms such as cough with secretion (36%), dry cough (23%), fatigue (19%), wheezing (9%), chest pain (5%). Of the pathologies, bronchitis (40%) and rhinitis (23%) were the most reported. CONCLUSION: There is a need for greater participation of health professionals in work environments such as libraries, aimed at promoting health, safety, and education at work.(AU)

Extracorporeal membrane oxygenation for severe Middle East respiratory syndrome coronavirus.

BACKGROUND: Middle East respiratory syndrome (MERS) is caused by a coronavirus (MERS-CoV) and is characterized by hypoxemic respiratory failure. The objective of this study is to compare the outcomes of MERS-CoV patients before and after the availability of extracorporeal membrane oxygenation (ECMO) as a rescue therapy in severely hypoxemic patients who failed conventional strategies. METHODS: We collected data retrospectively on MERS-CoV patients with refractory respiratory failure from April 2014 to December 2015 in 5 intensive care units (ICUs) in Saudi Arabia. Patients were classified into two groups: ECMO versus conventional therapy. Our primary outcome was in-hospital mortality; secondary outcomes included ICU and hospital length of stay. RESULTS: Thirty-five patients were included; 17 received ECMO and 18 received conventional therapy. Both groups had similar baseline characteristics. The ECMO group had lower in-hospital mortality (65 vs. 100%, P = 0.02), longer ICU stay (median 25 vs. 8 days, respectively, P < 0.01), and similar hospital stay (median 41 vs. 31 days, P = 0.421). In addition, patients in the ECMO group had better PaO2/FiO2 at days 7 and 14 of admission to the ICU (124 vs. 63, and 138 vs. 36, P < 0.05), and less use of norepinephrine at days 1 and 14 (29 vs. 80%; and 36 vs. 93%, P < 0.05). CONCLUSIONS: ECMO use, as a rescue therapy, was associated with lower mortality in MERS patients with refractory hypoxemia. The results of this, largest to date, support the use of ECMO as a rescue therapy in patients with severe MERS-CoV.

Prevalencia de síntomas respiratorios y riesgo de obstrucción al flujo aéreo en ginebra - valle del cauca / Prevalence of respiratory symptoms and risk of obstruction to air flow in ginebra - valle del cauca / Prevalência de sintomas respiratórios e riscos de obstrução ao fluxo de aire em ginebra - valle del cauca

RESUMEN Antecedentes y Objetivo: La prevalência de los principales síntomas respiratorios en Ginebra (Valle del Cauca) es desconocida. Este estudio busca investigar la prevalencia de disnea, tos, sibilancias y expectoración en Ginebra, un municipio rural de Colombia. Métodos: Se realizó un estudio de corte transversal, con una estrategia de muestreo por conglomerados para tener una muestra representativa de adultos mayores de 40 años. Cada paciente fue entrevistado con dos cuestionarios, el cuestionario de síntomas respiratorios Ferris validado para el español y el cuestionario de función pulmonar (LFQ), de este último, un puntaje menor o igual a 18 puntos fue considerado como riesgo de obstrucción al flujo aéreo. El análisis de datos fue realizado con software estadístico, el tamaño de muestra fue de 115 sujetos (prevalencia 50%, precisión 10% y porcentaje de pérdida del 20%), las variables cuantitativas se resumieron en frecuencias y porcentajes y las variables cuantitativas en medianas y rangos intercuartílicos, la prevalencia de síntomas respiratorios se calculó con un intervalo de confianza del 95% y se realizaron cruces exploratorios entre las variables de síntomas respiratorios y antecedentes exposicionales. Resultados: 146 sujetos, 2 pérdidas, mediana de edad 60,5 años (RIQ:22), 52,1% hombres, prevalencia de tos 18,1% (IC95%:11,8-24,3), expectoración 20,1% (IC95%:13,9-27,1), sibilancias 28,2% (IC95%:21,1-35,9), disnea 33,3% (IC95%:25-41), personas a riesgo de limitación flujo aéreo 19,4% (IC95%:14,2-28,4). En la realización de cruces exploratorios se obtuvo una relación entre el número de paquetes año y la presencia de tos (p=0,008), antecedente de exposición a leña y tos (p=0,008), número de paquetes año y expectoración (p=0,018), sibilancias y consumo de cigarrillo (p=0,047), disnea y antecedente de enfermedad coronaria (p=0,028), disnea y antecede de hipertensión arterial (p=0,037). Conclusión: La disnea es el síntoma respiratorio más frecuente en pacientes mayores de 40 años en Ginebra (Valle del Cauca), el antecedente de tabaquismo se relacionó con tos y sibilancias. La utilización de un cuestionario de síntomas respiratorios puede ser útil para identificar pacientes con riesgo de obstrucción al flujo aéreo cuando se compara con el auto-reporte de enfermedad respiratoria.

ABSTRACT Background and objective: The prevalence of main respiratory symptoms in Ginebra (Valle del Cauca) is unknown. This study aimed to investigate dyspnea, cough, wheezes and expectoration in Ginebra a Town of Colombia. Methods: A cross-sectional design and a random, conglomerates-sampling strategy were used to provide representative samples of adults aged > 40 years. Each participant was interviewed with two questionnaires, validated Spanish version of the Ferris Respiratory Questionnaire and Lung Function Questionnaire (LFQ), of the latter, and a score less or equal 18 points was considered with risk of obstructive airflow. Analysis was performed using statistical software, sample size of 115 subjects (prevalence 50%, precision 10% and lost percentage 20%), the variables quantitative were summarized with frequencies and percentages, and the variables qualitative in Median and range interquartile, the prevalence of respiratory symptoms was calculated with CI95%, exploratory analysis were made with respiratory symptoms variables and exposure antecedents. Results: 146 participants, with 2 missing, Median of age 60,5 years (IQR: 22), 52,1% men, prevalence of cough 18,1% (CI95%: 11,8-24,3), expectoration 20,1% (IC95%:13,9-27,1), wheezes 28,2% (IC95%:21,1-35,9), dyspnea 33,3% (CI95%:25-41), subjects with risk of airflow obstruction 19,4% (CI95%:14,2-28,4). Exploratory analysis showed relationship between package-year index and cough (p=0,008), wood smoke exposure and cough (p=0,008), package-year index and expectoration (p=0,018), wheezes and smoking exposure (p=0,047), dyspnea and coronary disease (p=0,028), and dyspnea and arterial hypertension (p=0,037). Conclusion: Dyspnea is the respiratory symptom more frequent in Ginebra (Valle del Cauca), the antecedent of smoking was relationship with cough and wheezes. Using a questionnaire of respiratory symptoms can be useful to identify patients with risk of airflow obstruction, when is compared with the auto-report of respiratory disease.

RESUMO Antecedentes e objetivo: A prevalência de sintomas respiratórios principais em Ginebra (Valle del Cauca) é desconhecida. Este estudo teve como objetivo investigar a dispneia, tosse, sibilos e expectoração em Ginebra, uma cidade da Colômbia. Métodos: Um desenho transversal e uma estratégia aleatória de amostragem de conglomerados foram utilizados para fornecer amostras representativas de adultos com idade> 40 anos. Cada participante foi entrevistado com dois questionários, versão validada em espanhol do Questionário Respiratório Ferris e Questionário de Função Pulmonar (LFQ), sendo este último considerado menor ou igual a 18 pontos com risco de fluxo obstrutivo de ar. A análise foi realizada utilizando software estatístico, tamanho de amostra de 115 indivíduos (prevalência 50%, precisão 10% e porcentagem perdida de 20%), as variáveis quantitativas foram resumidas com freqüências e porcentagens, e as variáveis qualitativas na mediana e intervalo interquartil, a prevalência de Os sintomas respiratórios foram calculados com IC95%, foram realizadas análises exploratórias com variáveis de sintomas respiratórios e antecedentes de exposição. Resultados: 146 participantes, com 2 perdidos, médios de idade 60,5 anos (IQR: 22), 52,1% homens, prevalência de tosse 18,1% (CI95%: 11,8-24,3), expectoração 20, 1% (IC95%: 13,9-27,1), sibilos 28,2% (IC95%: 21,1-35,9), dispnéia 33,3% (CI95%: 25-41), indivíduos com risco de obstrução do fluxo aéreo 19,4% (CI95%: 14,2-28,4). A análise exploratória mostrou relação entre índice do ano da embalagem e tosse (p = 0,008), exposição à fumaça da madeira e tosse (p = 0,008), índice do ano da embalagem e expectoração (p = 0,018), sibilos e exposição ao tabagismo (p = 0,047) dispnéia e doença coronária (p = 0,028) e dispnéia e hipertensão arterial (p = 0,037). Conclusão: A disnea é o sintoma respiratório mais freqüente em Ginebra (Valle del Cauca), o antecedente do tabagismo foi relação com tosse e sibilância. O uso de um questionário de sintomas respiratórios pode ser útil para identificar pacientes com risco de obstrução do fluxo aéreo, quando comparados com o auto-relato de doenças respiratórias.

Exposure to Cooking Fumes and Acute Reversible Decrement in Lung Functional Capacity.

BACKGROUND: Being exposed to cooking fumes, kitchen workers are occupationally at risk of multiple respiratory hazards. No conclusive evidence exists as to whether occupational exposure to these fumes is associated with acute and chronic pulmonary effects and symptoms of respiratory diseases. OBJECTIVE: To quantify the exposure levels and evaluate possible chronic and acute pulmonary effects associated with exposure to cooking fumes. METHODS: In this cross-sectional study, 60 kitchen workers exposed to cooking fumes and 60 unexposed employees were investigated. The prevalence of respiratory symptoms among these groups was determined through completion of a standard questionnaire. Pulmonary function parameters were also measured before and after participants' work shift. Moreover, air samples were collected and analyzed to quantify their aldehyde, particle, and volatile organic contents. RESULTS: The mean airborne concentrations of formaldehyde, acetaldehyde, and acrolein was 0.45 (SD 0.41), 0.13 (0.1), and 1.56 (0.41) mg/m3, respectively. The mean atmospheric concentrations of PM1, PM2.5, PM7, PM10, and total volatile organic compounds (TVOCs) was 3.31 (2.6), 12.21 (5.9), 44.16 (16.6), 57 (21.55) µg/m3, and 1.31 (1.11) mg/m3, respectively. All respiratory symptoms were significantly (p<0.05) more prevalent in exposed group. No significant difference was noted between the pre-shift mean of spirometry parameters of exposed and unexposed group. However, exposed workers showed cross-shift decrease in most spirometry parameters, significantly lower than the pre-shift values and those of the comparison group. CONCLUSION: Exposure to cooking fumes is associated with a significant increase in the prevalence of respiratory symptoms as well as acute reversible decrease in lung functional capacity.

Risk factors for persistence of lower respiratory symptoms among community members exposed to the 2001 World Trade Center terrorist attacks.

OBJECTIVES: We studied the course of lower respiratory symptoms (LRS; cough, wheeze or dyspnoea) among community members exposed to the 9/11/2001 World Trade Center (WTC) attacks during a period of 12-13 years following the attacks, and evaluated risk factors for LRS persistence, including peripheral airway dysfunction and post-traumatic stress disorder (PTSD). METHODS: Non-smoking adult participants in a case-control study of post-9/11-onset LRS (exam 1, 2008-2010) were recruited for follow-up (exam 2, 2013-2014). Peripheral airway function was assessed with impulse oscillometry measures of R5 and R5-20. Probable PTSD was a PTSD checklist score ≥44 on a 2006-2007 questionnaire. RESULTS: Of 785 exam 1 participants, 545 (69%) completed exam 2. Most (321, 59%) were asymptomatic at all assessments. Among 192 participants with initial LRS, symptoms resolved for 110 (57%) by exam 2, 55 (29%) had persistent LRS and 27 (14%) had other patterns. The proportion with normal spirometry increased from 65% at exam 1 to 85% at exam 2 in the persistent LRS group (p<0.01) and was stable among asymptomatic participants and those with resolved LRS. By exam 2, spirometry results did not differ across symptom groups; however, R5 and R5-20 abnormalities were more common among participants with persistent LRS (56% and 46%, respectively) than among participants with resolved LRS (30%, p<0.01; 27%, p=0.03) or asymptomatic participants (20%, p<0.001; 8.2%, p<0.001). PTSD, R5 at exam 1, and R5-20 at exam 1 were each independently associated with persistent LRS. CONCLUSIONS: Peripheral airway dysfunction and PTSD may contribute to LRS persistence. Assessment of peripheral airway function detected pulmonary damage not evident on spirometry. Mental and physical healthcare for survivors of complex environmental disasters should be coordinated carefully.

Respiratory Symptoms and Lung Function among Greek Cotton Industry Workers: A Cross-Sectional Study.

BACKGROUND: Workers in cotton industry are occupationally exposed to various dust-related hazards. The nature of these agents and the respective exposure levels depend on the cotton industry specific sector. These exposures could be associated with respiratory symptoms and changes in lung function parameters. OBJECTIVE: To evaluate associations between occupational exposure and respiratory function as well as reported symptoms in several groups of workers at different stages of the cotton industry in a vertical approach that covers all the major sectors-from cotton ginning to weaving and fabric production. METHODS: A questionnaire on respiratory symptoms and individual as well as workplace characteristics was completed by 256 workers at the cotton industry and 148 office workers (control group). Both groups underwent spirometry. RESULTS: Workers in cotton industry reported a higher prevalence of severe dyspnea (p=0.002) and wheezing (p=0.004) compared to the control group. Also they were found to have a lower predicted FEV1% (p<0.029) and lower FEV1/FVC (p<0.001) values. In addition, a higher prevalence of FEV1% <80% (p<0.001) and FEV1/FVC <70% (p=0.041) were found among textile workers. Similar results were found for non-smoker textile workers compared to non-smoker control group workers. Those working in cotton ginning mills recorded the highest decrease of spirometric values. Duration of employment in cotton industry and smoking use were found to be predictors of lung function decline for cotton industry workers. CONCLUSION: Occupational exposure to cotton dust was associated with increased prevalence of respiratory symptoms and obstructive pattern in pulmonary function test.

The psychometric properties of the Leicester Cough Questionnaire and Respiratory Symptoms in CF tool in cystic fibrosis: A preliminary study.

BACKGROUND: There are few tools to quantify the impact of cough in cystic fibrosis (CF). The psychometric properties of the Leicester Cough Questionnaire (LCQ) and Respiratory Symptoms in CF (ReS-CF) tool were investigated in adults with CF. METHODS: Validity and reliability were assessed in clinically stable participants who completed the questionnaires twice, along with the Cystic Fibrosis Questionnaire - Revised (CFQ-R). Responsiveness was assessed by change in questionnaires following treatment for an acute respiratory exacerbation. RESULTS: Correlations between the LCQ and CFQ-R respiratory domain were moderate (n=59, rs=0.78, p<0.001). Correlations between ReS-CF and CFQ-R respiratory domain were fair (rs=-0.50, p<0.001). The LCQ total score was repeatable (ICC 0.92, 95%CI 0.87-0.96, n=50). In those reporting improvement in symptoms following treatment (n=36), LCQ total score had a mean change of 4.6 (SD 3.7) and effect size of 1.2. CONCLUSIONS: The LCQ and ReS-CF appear to be valid, reliable and responsive in CF. TRIAL REGISTRATION: www.anzctr.org.au: ACTRN12615000262505.

Impaired gas exchange: accuracy of defining characteristics in children with acute respiratory infection / Troca de gases prejudicada: acurácia das características definidoras em crianças com infecção respiratória aguda / Deterioro del intercambio gaseoso: precisión de las características definitorias en niños con infección respiratoria aguda

to analyze the accuracy of the defining characteristics of the Impaired gas exchange nursing diagnosis in children with acute respiratory infection.

analisar a acurácia das características definidoras do diagnóstico de enfermagem troca de gases prejudicada, em crianças com infecção respiratória aguda.

analizar la precisión de las características definitorias del diagnóstico de enfermería Deterioro del intercambio gaseoso, en niños con infección respiratoria aguda.